Provider Demographics
NPI:1588321640
Name:FAMILY HOMECARE OF ILLINOIS INC
Entity type:Organization
Organization Name:FAMILY HOMECARE OF ILLINOIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HABIB
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:312-200-2272
Mailing Address - Street 1:776 W BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4482
Mailing Address - Country:US
Mailing Address - Phone:312-200-2272
Mailing Address - Fax:877-583-4749
Practice Address - Street 1:776 W BARTLETT RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4482
Practice Address - Country:US
Practice Address - Phone:312-200-2272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health